When ill, 'can take medicine without injection, can inject without infusion' is the World Health Organization drug principle. But in our country, many people think the infusion is fast, and the scene of "hanging bottle forest" often appears in the infusion Hall of the hospital. So what are the benefits of infusion for human body? Is infusion really equal to chronic suicide?
However, excessive infusion will lead to some adverse consequences. Recently, more than ten hospitals in Jilin announced the cancellation of adult general outpatient infusion.
"You can take medicine without injection, you can inject without infusion" is the basic principle of medication, but this principle is often in reverse order in reality: for example, people around you always hear people say "infusion, it's good fast". At present, China is known as a "big infusion country" with 8 bottles per capita per year, which is far higher than the international average of 2.5-3.3 bottles per capita.
However, changes are taking place. It is understood that China has not made unified regulations on outpatient infusion of hospitals at the national level, but up to now, Anhui, Zhejiang, Jiangsu, Jiangxi, Guangxi, Shenzhen and other provinces and cities have controlled or cancelled adult outpatient infusion treatment, and many local medical institutions are also gradually following up. Can these measures curb over treatment?
Recently, more than ten hospitals in Jilin Province have cancelled the routine outpatient infusion for adults. These hospitals include the first hospital of Jilin University, the second hospital of Jilin University, the people's Hospital of Jilin Province, etc. Entering the first hospital of Jilin University, the original general outpatient infusion area has been closed. In 2018, 60000 patients were there for intravenous infusion. Wei Feng, director of the medical department of the first hospital of Jilin University, said that the abolition of adult outpatient infusion is one of the important measures to implement "graded diagnosis and treatment".
"By canceling adult intravenous infusion, we can liberate a large number of medical staff and make them to places where they are more needed. Our hospital's foothold is to look at patients with acute, critical, severe and difficult complex diseases, and these medical staff will have more energy to look at these diseases. "Wei Feng said.
The so-called hierarchical diagnosis and treatment is' the first diagnosis at the grass-roots level, two-way referral, acute and slow treatment, upper and lower linkage '. Jilin health and Health Commission said that for adults with critical condition in general outpatient clinic, the hospital preferred to receive hospital treatment, and those who meet the indication of emergency treatment can go to emergency treatment; if the patient's condition is relatively stable, outpatient doctors can issue prescriptions and suggestions to the community outpatient transfusion.
In fact, in recent years, all over the country has been exploring the elimination of outpatient infusion. As early as 2012, the first hospital of Peking University cancelled the infusion area directly in the new outpatient building when the outpatient building was relocated. Pan Yisheng, Secretary of the Party committee of the first hospital of Peking University, said that what patients get is more reasonable medical standards.
In Anhui, from August 18, 2014, Anhui took the lead in publishing the 'negative list' of clinical infusion, clearly proposed 8 indications of infusion, and listed 53 common diseases in outpatient clinics such as upper respiratory tract infection and infantile diarrhea that do not need infusion, so as to strictly control the abuse of clinical infusion. At present, many provinces, such as Anhui, Zhejiang, Jiangsu, Jiangxi, Guangxi, Shenzhen, etc., have controlled or cancelled the infusion treatment in adult outpatient clinics. It is worth noting that, even in places where outpatient infusion is cancelled, pediatrics and emergency treatment in most hospitals are not included.
The harm of excessive transfusion in outpatient service has aroused concern, but many public wrong drug use concepts are still deeply rooted. Many patients or family members often only see the so-called "fast treatment" of transfusion, and not a few actively require transfusion. Hong Yucai, director of emergency department of Shao Yifu Hospital Affiliated to Zhejiang University Medical College, once mentioned that doctors often need to spend a lot of time explaining when infusion is needed.
Hong Yucai said: 'unless the patient's digestive tract cannot be used and needs medication, it can only be used intravenously (infusion), and there are some serious infections. Sometimes only intravenous medication and no oral medication are available. Only in these circumstances can we let him infuse. After screening, few patients really meet the infusion conditions. '
According to statistics, 70% of the drugs in outpatient transfusion contain antibiotics. The abuse of antibiotics will increase the production of drug-resistant bacteria, and eventually lead to no drug available. In 2016, containment of bacterial drug resistance has become a national action. According to the national action plan for containment of bacterial drug resistance jointly issued by 14 departments, 1-2 brand-new antibacterial drugs will be developed and listed by 2020; the proportion of retail pharmacies selling antibacterial drugs by prescription will basically reach full coverage.
Guo Yanhong, deputy director of the medical administration of the national health and Health Commission, said that the "negative list" management should be carried out to clarify the conditions for the prohibition or restriction of the use of antibacterial drugs. Continue to do a good job in monitoring, grasp the trend of prevalence and change of drug-resistant bacteria in China, and strengthen supervision and publicity.
At present, the antibacterials treatment work of the national health and Health Commission has entered the stage of institutionalized and normalized management, which will strengthen the management of intravenous infusion and reduce the unreasonable use of antibacterials due to the interest. How far is the practice from all over the country to control or cancel outpatient infusion? The answer is given in the history of the director of the Department of pharmacy management and clinical pharmacy of Peking University School of pharmacy.
He said: 'it's hard to estimate the time, but the next step is to conduct a comprehensive survey of pilot projects across the country. On the basis of the survey, we can summarize relevant experience, which are medical laws that should be raised to the national level to formulate norms, which are lessons that can be combined with public reflection and relevant policies to make a more reasonable national compliance Fan's system documents. '